AB0955 WITHDRAWAL FROM PROFESSIONAL LIFE DUE TO HIGH DISEASE ACTIVITY IN PATIENTS WITH ANKYLOSING SPONDYLITIS TREATED WITH TUMOUR NECROSIS FACTOR INHIBITORS AND/OR NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN ROUTINE CARE: RESULTS FROM THE MULTINATIONAL “INVISIBLE” STUDY
Authors: J. Brandt-Juergens, J. Haschka, R. Finsterwalder, A. Casier, A. Kill, S. Dierckx
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing Spondylitis (AS) is an inflammatory rheumatic disease affecting the axial skeleton (1), with a prevalence of up to 0.5% in Europe (2; 3), and occurs equally in men and women [4]. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and biological Disease-Modifying Antirheumatic Drugs (bDMARDs) such as Tumour Necrosis Factor inhibitors (TNFi) are the first choice in pharmacological treatments for AS patients (5; 6). Data on employment situation in correlation with disease activity and disease duration in AS patients treated in real life settings in Europe are limited. <h3>Objectives</h3> To evaluate the disease activity status and assess participation in professional life in relation to treatment response following at least 12 weeks of treatment with TNFi and/or NSAIDs. <h3>Methods</h3> INVISIBLE was a multinational, cross-sectional, non-interventional study in Germany, Austria and Belgium. Adult patients with confirmed diagnosis of AS for at least 6 months and ongoing treatment with TNFi and/or NSAIDs for at least 12 weeks prior to enrolment were included. Primary data were collected at a single visit using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and collecting current demographic data including employment status using the categories employed, unemployed, parental leave, retired and sick leave (&gt;6 weeks). Medical history data were collected from available patient files. <h3>Results</h3> 747 adult AS patients (67% male) were included in this analysis. The patients were 47.9±13.1 years of age. Symptom duration was 18.2±13.0 years. 22.9% of patients received NSAIDs, 41.6% TNFi, 29.7% both NSAIDs and TNFi, and 5.4% other treatment for at least 12 weeks prior to enrolment. BASDAI was 3.4±2.3 and ASDAS 2.2±1.0. Patient's disease activity assessment (Visual Analogue Scale 0-100) showed on average 35.8±27.5 and patients with BASDAI ≥4 reported significantly higher disease activity compared to patients with BASDAI &lt;4 (59.7±20.7 vs. 20.7±19.7, p&lt;0.001). 72.5% of patients were employed and 9.9% unemployed or in sick leave for &gt;6 weeks. More patients with a BASDAI ≥4 were unemployed or in sick leave regardless of type of treatment and duration of symptoms compared to patients with a BASDAI &lt;4 (see Table 1). <h3>Conclusion</h3> Results from the non-interventional study INVISIBLE showed that a higher proportion of AS patients receiving NSAIDs and/or TNFi with high disease activity according to BASDAI are not participating in professional life. These results suggest that in some patients, disease control and treatment response are suboptimal under current treatment strategy. <h3>References</h3> [1]<b>Braun, J &amp; J, Sieper.</b><i>Lancet.</i> 2007, Bd. 369, S. 1379–90. [2]<b>Braun, J, et al.</b><i>Arthritis Rheum.</i> 1998, Bd. 41, 1, S. 58-67. [3]<b>Dean, LE, et al.</b><i>Rheumatology.</i> 2014, Bd. 53, S. 650-657. [4]<b>Rudwaleit, M, et al.</b><i>Ann Rheum Dis.</i> Jun 2009, Bd. 68, 6, S. 777-83. [5]<b>Dougados, M, et al.</b><i>Ann Rheum Dis.</i> 2002, Bd. 61, suppl 3, S. 40–50. [6]<b>Braun, J, et al.</b><i>Ann Rheum Dis.</i> 2006, Bd. 65, S. 316–20. [7]<b>Feldtkeller, E, et al.</b><i>Rheumatol Int.</i> 2003, Bd. 23, S. 61–66. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Jan Brandt-Juergens Consultant of: Abbvie, Affibody, BMS, Gilead, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, UCB, Judith Haschka Speakers bureau: Eli Lilly, Amgen, Consultant of: Eli Lilly, Richard Finsterwalder Employee of: Novartis Pharma GmbH, Aurélie Casier Employee of: N.V. Novartis Pharma S.A., Angela Kill Employee of: Novartis Pharma GmbH, Stéphanie Dierckx: None declared.